Why seek a private psychological assessment?

I recently spoke with a very happy father. He told me that he was canceling our appointment for psychological testing because his insurance company was going to arrange for him to have his child tested for only $15. And as I wished him well and hung up the phone, I understood why he sounded so excited. Fifteen dollars compared to the cost of a private assessment, well who wouldn’t be thrilled? And if you get an assessment though the school system it is free. Free sounds awfully good compared to expensive private testing, but the problem is that like with many things in life, if it sounds too good to be true to be, it probably is. As a former special education teacher, I have seen some very good assessments done by school system staff, however I also know the limitations of time, resources and even training that can negatively impact the quality of your child's assessment.

So what are you paying for when you invest in a private assessment? You are paying for time, expertise, and information you can trust. One of the first considerations is time. There’s no getting around the amount of time that a psychologist should spend producing a quality report, and ideally it is the psychologist’s time. Some psychologists do not do their own testing, instead they pass you off to a technician after the initial interview. The test administration, consulting, scoring and writing is very labor intensive, and in my opinion, it should be. No one wants to be treated by someone who is in a rush or taking short-cuts. Its worth paying for someone to make your case a priority. A private psychological evaluation should be custom designed around what you want to determine, as well as your child’s strengths and weaknesses. Tests and procedures should be thoughtfully selected, not simply used because they are the only ones you have. It is crucial to find a psychologist (or neuropsychologist) who has many tools at his or her disposal and the expertise to know how to use them.

It is unlikely that a psychologist will make useful recommendations unless he or she takes the time to study how an individual solves a variety of problems in the form of tests, tasks, and even play. When you walk out of a psychologist’s office, you should have a large document in your hand that gives you insight into how your mind (or your child’s mind) works and lays out a plan for what steps to take next. A comprehensive assessment should lead to specific, concrete, recommendations that address educational interventions, therapy, strategies for home, parenting advice, and information to inform medical treatments as appropriate.

When I do a psychological evaluation, I begin by budgeting six hours of ‘face to face’ time with the individual and his/her family. This is as much as three times the amount of time many people spend doing a psychological evaluation. My psychological evaluations resemble the neuropsychological assessments that I was trained to do as in intern at a pediatric hospital in Baltimore. I study the individual’s functioning exhaustively until I’m satisfied that I understand the problem, both what it is and what I can safely determine that it is not. After gathering my data, I start calling everyone I have permission to consult with (physicians, teachers, tutors, even relatives) to get a complete picture of how the person is doing across home, school, and work. I review old testing reports and work samples. Then I set up to work writing your evaluation. I do not fill your name into a template. I do not dictate my reports to a transcription service. I do not cut and paste ‘cookie cutter’ recommendations into the report. Finally, the family and I sit down and have a feedback session, where we talk about the findings in detail and spend time problem solving. I believe this level of care is what every person suspected of having mental health problems or disabilities deserves.

I find that many people under estimate the importance of mental health, I used to be one of those people untill Anxiety came into my life. I could live with the torn menisucus I'm getting fixed soon but I can't imagine living with Anxiety without the excellant advice I've received from my Psychologist.

My wife is suffering from fits for the past 15 years. She was under treatment from neuro-psyhiatric. He prescribed Lonazep 2mg per day. Though after taking the drug for such a long time she now will not fall down and kiking her legs , froth doesnt come out of her mouth. But daily 3-4 times she forgets every thing.
With the advise from one of the doctor I have taken her to a Physiatric physician and he prescribed GABARICH 150mg in the morning and 300 mg in the night,along with TARZINE 10 mg one in the night. After taking the tablets the frquency of the forgetfull nature increased daily 5 times.She started shiverring. I spoke to the doctor and he said to give 0.5mg LONAZEP in the morning along with those medicine. Fed up with the tablets, I have stopped all the tablets for the time being. Now she is not getting the forgetfullness. Only a day has passed. Will this method will it work on long run. Please suggest. Is there any good treatment for this type of disease. Kindly advise.

Dear Aarasan, as I am not a psychiatrist, I can not advise you on medication. It will be important for you wife to be seen if she is having concerning side effects or not adhereing to her medication plan as prescribed. Please contact your psychiatrist and/or primary care physician as soon as possible.

I had cervical neck surgery 3 months ago. After surgery, there was no desire or feeling to poop. The MRI at fist showed full colon and intestines, then after about 30 days, nothing was still working and then we went to the hydrocolonics clinic and had everything cleaned out. Since then, nothing has happened, 100 days with no BM. I have to go to the Hydrocolonics clinic every 3 days now to get cleaned. They tried everything form Reglan to you name it. THe doc who did the surgery will not talk or answer any questions, we found out that I had stopped breathing several times after the ventilator was removed in the OR. Then when I was finally breathing again after the crash cart came in 3 times, the doc ordered the recovery room anesthesiologist to give me 10 mg of Valium and 160 mg of Oxycontin. No one knows what's wrong and I have been passed to 7 doctors now. All everyone seems to care about if I am suing the doctor who did the surgery. Is there anyone who knows what this is??? I was 100% fine prior to surgery.

I was also given Reglan during surgery, and I had no problem for that medication.

Thank you, rebecca, for taking such good care of your patients. When I was a kid, I had really bad ADD, but this was before people knew about it and before it was treated. i just was not able to listen, not even to a story. so, i was a horrible student and in sixth grade, this teacher who wanted to be a psychologist assembled all the best and the worst students, and he administered an intelligence test to us. I did not listen to the instructions and had no idea what it was, and my parents were also never told about this test. at the end of the year, my mother was told that I had failed the class and that I was not allowed to repeat it either, and that I had to be enrolled in a school for retarded children. (This was in Germany) She found out about the intelligence test and that my intelligence score was 50 and that clearly my grades reflected this, and there was no doubt. My mother really used good judgment and she hired a psychologist to reevaluate me properly, and for several hours vs. a 45 minute test invented by a hobby psychologist. he also treated me for a while. he told my mother that my intelligence was perfectly normal but that I had really low self esteem. to make a long story short, the only thing I ever learned in those first 10 years of school is how to read and write and otherwise NOTHING except that I was retarded. I then came to the States at 17, and it was in a foreign language that I really for the first time learned how to learn. i went to a Quaker Boarding school and the teachers really took interest in me and they thought I must be really smart coming from germany. so i secretly worked really hard because I so badly wanted to live up to their expectations, and I did. I always performed according to what the teachers thought. if they thought I was smart i was a really good student and when they told me I was stupid I was really bad. I am still missing a lot of the basic education and when my 12 year old asks me a question about homework, i panic. i don't understand most of his homework. yet, I caught up fast after I turned seventeen and moved to the US, and learning became easier and easier the further up the education. In graduate school, I excelled, except that my advisor highly suggested I was in the wrong field, Psychology, and should switch to writing full time. I guess he was not used to being entertained by a student thesis, and laughing much of the time. (Sorry about this sloppy writing. it's late and I am too tired to edit)) Thanks again.

Check the bc support group at Revolutionhealth. Not only is it a great group, but there is a topic, or post category exclusively for this topic and with a lot of feedback. i found it incredibly helpful and no way will I have this done. but we all make those decisions for ourselves and there is no right or wrong answer, except, from what I learned, you have to do it for yourself and not to please someone else. This group is great though and your sister may also find it useful.

As someone who is involved in education and have 10 years of experience in a public school system with special education assistance - I do not truly agree with your statements on general evaluations and untrained staff.

Each "M team" is developed to give a student the utmost priority in education as well as private assistance if needed. There are outside agencies that are called in to additionally give the student xtra support if needed at no cost to the parents.

There are large amounts of funding given to public education to accomadate these students and more on it's way. In fact many regular education students suffer with budget cuts and special education continues to grow.

I believe any parent involved with special education in their public school is recieving superior service - sometimes too much.

And these students regardless of their needs are getting above services from the support of other students- parents-teachers and administration.

If you went out in search privately for the services offered as a tax payer with a special education student in a public school- you would pay dearly for these services and possiblyhave a fight with the health insurance companies to pay.

As a school psychologist, I strongly disagree with this article. I evaluate a number of children each year and I would never short-cut. Considering that the psychological evaluation is part of the special education determination process, I spend a great deal of time assessing the whole child. You may read this and think that I am the exception but I can assure you that is not the case. In this position, I have read countless psychological evaluations completed by districts all over the world. I find that psychologicals completed by school psychologists are easier to read and are more clear cut with useful tables and graphs with the interest of the reader in mind. Remember the school has nothing to gain in this situation so it is important to them that they determine the strengths and needs of the child, for the child's sake and for no other reason. I find that evaluations completed by outside sources try to give you what you pay for by adding a bunch of statistics and a week-long observation of the child's every move. The reports are usually very lengthy but provide limited information. I strongly recommend seeking advice through the school system as a first step. If the school professionals feel as though your child is doing well and that evaluation is not warranted, you may want to spend the money for a private psychological evaluation. However, if you choose that road remember that the results of the private evaluation may be skewed so that the results reflect what you, the consumer, would like and that your child may not have that profile at all. Once completed and paid for, the school system does not have to accept the private evaluations so it may turn out to be a bigger waste of money....and what a high amount of money it is. My suggestion is to trust the professions in your school, your tax dollars will cover the expense.

Rebecca,
I hope that your 46 line litany -- which neither adequately nor professionally answers the question "Why should I have a private psychological assessment?" -- is not an indication of the quality of your psychological evaluations.

Others,
"Why should I have a private psychological assessment?"
-If the presenting concerns do not fall under the "umbrella of conditions" that the school system (or any civil service department) is required to treat.
- If you have concerns regarding the validity of the diagnosis, prognosis, or treatment recommendations rendered by the civil service clinician(s).
- If a recommendation or referral is made for a specialist or "expert in the field" to evaluate a particular concern (e.g., a neuropsychologist with prescription privileges to assess the behavioral and psychopharmacological needs of a severely autistic adolescent who head bangs and has Tardive Dyskinesia/ Akathisia.)
- Other situations as may arise.

I wanted to comment on the post above. I have tardive dyskinesia in a variety of severe forms including tardive monoclonus and tardive psychosis (which is official study by a psychiatric researcher). Tardive dyskinesia from my knowledge only comes from the long term use of antipsychotics as well as other medications. Though thankfully I am now on an antipsychotic that doesn't cause tardive dyskinesia, glycine (which is in Phase II FDA study) with the exception of Clozaril (which has severe effects of its own such as blood dyscreias) all of the other antipsychotics can. They are appropriately used for any form of psychosis such as schizoaffective disorder such as I have (though hopefully they will be replaced by the glutamate antagonists as a class of medications when they are through the various studies). However, autism is a developmental disability and from what I know that in itself cannot be treated with antipsychotics (unlike a mental illness). However, antipsychotics are often used for "behavior managment" for autism but since they do not treat the primary disability is it worth it with the risk of tardive dyskinesia especially among young people? I know that psychomoter agitation from akathesia and in myself tardive akathesia (before it was treated with muscle relexants, Klonopin and rhodiola) is often confused with psychosis and if a person is classed as "acting out" during this state and administered an antipsychotic unlike genuine psychotic behavior, since it will worsen the immediate statem the results can be fatal. Thusm unless actual clinical psychosis is present is it worth it to prescribe antipsychotics to people with autism? I am the board president of a non profit agency that advocates for people with disabilities but I do not feel comfortable posting the full information on the site but people may contact me in this regard. They can also contact me about the class of antipsychotics I am in study on but here is a link to one glutamate antagonist that will enter Phase III next year:
http://www.nytimes.com/2007/09/03/business/03drug.html?_r=1&oref=slogin
Children with autism have much to cope with. Unless there is a specific condition that can be treated with an antipsychotic, because of the risk of tardive dyskinesia constructive constructive behavior therapy (as opposed to aversive conditioning which is abusive) is probably the best way to control temper and outbursts.

I agree whole-heartedly. Getting an assessment done right is so important that it shouldn't be left to rushed assessments in schools. Psychological assessments aren't about finding problems in children, they are more about finding ways to improve their opportunities to learn and grow.

Hi Rebbeca your article is wonderful,Im in India im 32 years old im not married.I dont have problem in sex.But im afraid to marry a girl Because i have epilipsy for the last 24 years. I take Lonazep 1 Mg,Tegritol 200 MG.and Omez.(Very rarely i take fullnite).for the last ten years,Some times im stressed and blabering, Am i elegible for marriage.(im not comfortable to have sex with girls).Im in medication.What are the side effects of tegritol and lonazep for taking in long term basis.Please reply me,My mail id # is Sarahh.Saravanan@ Gmail.com.U can reach me @ 91-9543257411.

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